Indonesia to test 17 for bird flu in Sulawesi

[walker]

Indonesia to test 17 for bird flu in Sulawesi
13 Nov 2008 12:53:23 GMT
Source: Reuters
JAKARTA, Nov 13 (Reuters) - Seventeen people from the same neighbourhood in the Indonesian city of Makassar in South Sulawesi are due to be tested for bird flu after falling sick, a health ministry official said on Thursday. Chandra Yoga Adhitama, acting director-general of communicable disease control, said the group had been hospitalised after chickens in the surrounding area suddenly died.

"Some were hospitalised yesterday and some today. I think it is a precaution by our officials after chickens died there," Adhitama said.

He described the general health condition of the 17 as good and said that blood samples had been taken and would be sent to the health ministry laboratory in Jakarta for testing.

more:

Source: http://www.alertnet.org/thenews/newsdesk/JAK57510.htm

[beast]

17 in hospital with suspected bird flu

Andi Hajramurni and Suherdjoko ,  The Jakarta Post ,  Makassar and Semarang   |  Fri, 11/14/2008 7:05 AM  |  Headlines

A South Sulawesi hospital was overwhelmed as it admitted in two days 17 patients believed to have bird flu, an official said Thursday.

The patients, mostly children, presented with symptoms of the disease, such as a high fever, cough and respiratory problems, spokesman for Wahidin Sudirohusodo General Hospital in Makassar, Andi Kurnia Bintang, said.

Kurnia said the first patient, 5-year-old Salman, was hospitalized Wednesday morning, followed in the evening by his siblings Nurul Awaliah, 3, and Nur Fadillah, four months old, and four neighbors.

He said the patients, all residents of Sudiang subdistrict in Biringkanaya district, Makassar, were brought to the hospital after suffering a high fever for about two days.

“According to Salman’s parents, 27 chickens belonging to their neighbors died on Nov. 7. In the two days after that, their four chickens also died,” he said.

Kurnia said the hospital had conducted urgent tests for the first seven patients, with the results indicating the presence of  the H5N1 avian influenza virus.

The hospital is waiting for confirmation of the results from blood tests conducted by the Micro Laboratory of the Hasanuddin University Medical School and the Visual Conversion Reaction, he said.

He said the hospital had the other 10 patients admitted Thursday under observation while waiting for their test results.

“They showed symptoms of bird flu, such as a high fever and respiratory problems, but we are still waiting for the results of the rapid tests, thorax photos and blood tests,” the hospital’s emergency unit officer in charge Wasis Udaya said.

The hospital’s bird flu team held a meeting Thursday to help deal with the situation, as this is the first time they have received such a large number of bird flu patients.

The hospital, which had set aside 11 beds for bird flu patients, had to expand its facilities following the outbreak.

Head of the husbandry division of the Makassar Marine and Agriculture Office, Sulistiawati, said the results of tests conducted on the dead chickens in the area showed the birds were infected by the avian influenza virus.

“We have conducted rapid tests on the chickens and the results showed some of the chickens were positive (infected by the virus),” Sulistiawati said.

She said her office had culled 20 chickens and disinfected the birds’ cages in the subdistrict on Wednesday. 

Her team plans to gather all chickens in the area, hoping residents will voluntarily hand over their birds for culling.

Meanwhile, dozens of birds in the neighborhood of DS, 15, who died of bird flu in Semarang, Central Java, last week were culled Thursday.

The culling was conducted in a field in the Medoho area in Gayamsari district.

Central Java has had 14 cases of bird flu in humans with 11 deaths since 2003.


Source: http://www.thejakartapost.com/news/2008/11/14/17-hospital-with-suspected-bird-flu.html

[beast]

Suspected bird flu patients isolated

Andi Hajramurni and Suherdjoko ,  The Jakarta Post ,  Makassar, Semarang   |  Sat, 11/15/2008 10:59 AM  |  The Archipelago

The Wahidin Sudirohusodo regional hospital in Makassar, South Sulawesi, is continuing to isolate 17 patients of Biringkanaya district believed to have bird flu.

"Generally the patients are getting better," spokesperson for the hospital's bird flu team, Halik Saleh, said Friday.

Apart from a 2 year old named Ilham, the body temperatures of all other patients have returned to below 38 degrees Celsius.

"We are continuing to observe their progress, particularly because some poultry has tested positive to bird flu contamination," Halik said.

As a precaution, the hospital has been restricting staff and family members from visiting the patients in an effort to prevent any possible outbreaks of the disease.

The hospital, he said, is still waiting for the results of blood tests from the Health Ministry.

An initial test of all the patients' blood has indicated the presence of the avian influenza virus, H5N1. The same test by the micro laboratory of Hasanuddin University's School of Medicine in Makassar indicated the same results.

Halik said the hospital had decided not to use them as an indicator or reference for the illness.

"The only results we will refer to in order to treat our patients will be those from the laboratory of the health ministry's research and development center," he said.

The head of the Makassar Health Agency Naisyah Tun Azikin said all the samples required for testing had been sent to Jakarta on Thursday and Friday. The results should be known within a week.

Naisyah said in anticipation of a possible increase in suspected bird flu cases, his office had prepared two additional hospitals to treat them.

"Alhamdulillah (Praise be to God), none were admitted today," Naisyah said Friday.

A team of representatives from various government institutions culled 61 birds on Friday from Sudiang subdistrict where all the patients came from.

Nurmayanti, from the government team, said the culling was carried out over three consecutive days and had destroyed a total of 167 birds.

She said the team would continue culling the area within a one-kilometer radius to ensure there was no poultry left alive within the region.

Meanwhile in Semarang, Central Java, authorities have closed three chicken abattoirs in Gayamsari district.

The closures were made by local residents after 15-year old Dewi Sartika died Tuesday from bird flu.

Chairman of Siwalan Community Empowerment Institution Agus Supriyoto said residents, including Dewi's parents Sarjono and Sri Yakin, misinterpreted their daughter's symptoms as ordinary fever.

They were unaware it was bird flu until staff from the provincial and municipal health agencies informed them Tuesday. The following day they held a meeting discussing poultry culling in the region, where many of the 500 families reside there keep birds as pets.

"We carried out the culling Thursday," said Agus.


Source: http://www.thejakartapost.com/news/2008/11/15/suspected-bird-flu-patients-isolated.html

[Anonymous]

may all the gods protect us

[beast]

Indonesia says 17 in Sulawesi not infected with bird flu
20 Nov 2008 10:48:25 GMT
Source: Reuters
JAKARTA, Nov 20 (Reuters) - Bird flu has been ruled out as the cause of illness in 17 people from the same neighbourhood of Makasar in Sulawesi, Indonesia, a health ministry official said on Thursday.

The 17 were hospitalised this month after falling sick shortly after a rash of unexplained chicken deaths in the area.

"The result of the tests is negative," said Lily Sulistyowati, spokeswoman of the ministry, without giving details.

Suspected outbreaks raise concerns about rare human-to-human transmission or that the virus might have mutated into a form that can pass easily among people.

The country's largest known cluster of bird flu cases in humans occurred in May 2006 in the Karo district of North Sumatra province, when as many as seven people in an extended family died.

The World Health Organisation said at the time that limited human-to-human transmission could not be ruled out but that the virus samples from the scene did not show any significant genetic mutations.

Bird flu remains mainly an animal disease, but experts fear the H5N1 virus might mutate into a pandemic strain that would sweep the globe, possibly killing millions and hobbling economies.

Indonesia has the highest toll of any nation. Some 112 people have died because of the disease.

Last week, a health official said a 15-year-old Indonesian girl had died of bird flu in central Java, but Chandra Yoga Adhitama, acting director-general of communicable disease control, said tests showed bird flu was not responsible. (Reporting by Telly Nathalia; Editing by Sugita Katyal)


Source: http://www.alertnet.org/thenews/newsdesk/SP170904.htm

[beast]

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Commentary

Indonesia Denies H5N1 Lab Confirmatory Cluster in Sulawesi
Recombinomics Commentary 16:15
November 20, 2008
The sample inspection of blood by using Polymerase Chain Reaction (PCR) was carried out in the Hasanuddin University laboratory (Unhas) and was sent to the Department of Health

Initial tests of the first seven patients indicated the presence of the H5N1 avian virus.

The hospital was now awaiting confirmation of the results from blood tests done by the Micro Laboratory of the Hasanuddin University Medical School, he said.

The 17 were hospitalised this month after falling sick shortly after a rash of unexplained chicken deaths in the area.

"The result of the tests is negative," said Lily Sulistyowati, spokeswoman of the ministry, without giving details.

The above translations describe a large PCR confirmed H5N1 cluster in Sulawesi, Indonesia. The above wire service quotes do not include confirmation that the poultry deaths were due to H5N1 and provide yet another denial of lab confirmed H5N1cases reported by local media.

Although Indonesian denials have been met with skepticism previously, the latest case in Semarang, as well as the current cluster in Sulawesi, appears to signal a new level of denials.  Previous cases were highly suspect, but lacked lab confirmation.  The latest cases however, were lab confirmed, based on local media reports or wire service quotes from the lead physician, but were still denied by the Ministry of Health.

In the latest cluster, the circumstantial evidence strongly supports the local reports of H5N1 PCR confirmation.  The local poultry was H5N1 positive and at least four local slaughterhouses were closed permanently.  Fourteen of the patients were placed in isolation (which had a capacity of 14) with guards stationed at the isolation wing.  Three other hospitals were readied to receive additional bird flu patients.  Two more patients were recently admitted, including a sibling of one of the hospitalized patients.  The patients recovered after being treated with Tamiflu, but remained hospitalized until today.


Source: http://www.recombinomics.com/News/11200801/H5N1_Sulawesi_Denial.html

The denial of H5N1 confirmation of this large cluster also adds insight into the earlier statements by Ministry of Health head, Siti Fadilah Supari, who cited rapid treatment for the fall in H5N1 cases.  Of course rapid treatment does not reduce H5N1 infections unless the patients are highly contagious.  Early treatment would lead to recovery, which could also lower viral titers, leading to false negatives and failures to lab confirm.  Therefore rapid treatment could lead to a lowering of confirmed cases, and an artificial elevation of case fatality rates, because milder recovered cases would not be counted.  The case fatality rate in Indonesia s the highest in the world and has been around 80% since the first cluster was reported (including one confirmation) in 2005.

If confirmed, the 19 suspect cases in Sulawesi would be the largest H5N1 cluster reported to date, but today’s denial does not increase the confirmed cases or clusters in Indonesia, but significantly increases the level of concern.